Individual
BLAKE BAZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
24661 COOLIDGE HWY, OAK PARK, MI 48237-1449
(248) 398-4000
Mailing address
24661 COOLIDGE HWY, OAK PARK, MI 48237-1449
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011771
MI
Other
Enumeration date
05/26/2023
Last updated
06/27/2024
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